October is Sudden Infant Death Syndrome (SIDS) Awareness Month. SIDS is responsible for far fewer deaths than congenital disorders and disorders related to short gestation, though it is the leading cause of death in healthy infants after one month of age. It is the third leading cause of overall infant mortality and claims the lives of about 2,500 babies each year in the United States.

SIDS is defined as sudden death of an infant between one month and one year of age, the cause which remains unexplained after a thorough case investigation, including an autopsy, examination of the death scene and a review of clinical history. Most deaths due to SIDS occur between 2 to 4 months of age.

The American Academy of Pediatrics (AAP) says that all infants should be placed on their back for every sleep period. Side sleeping is not a safe alternative and is not advised. Placing infants in the proper sleeping position is one way that caregivers can reduce SIDS risk.

“Every caregiver should use the back sleep position with the infant during every sleep period,” said Dr. Lynn Walker, pediatric medical consultant for the MSDH. “Bed sharing is not recommended during sleep. Infants may be brought into bed for nursing or comforting, but should be returned to their own crib or bassinet when the parent is ready to return to sleep.”

Foremost among SIDS risk factors is stomach sleeping. Numerous studies have found a higher incidence of SIDS among babies placed on their stomachs to sleep than among those sleeping on their backs or sides. Some researchers have hypothesized that stomach sleeping puts pressure on a child’s jaw, therefore narrowing the airway and hampering breathing.

Another theory is that stomach sleeping can increase an infant’s risk of “rebreathing” his or her own exhaled air, particularly if the infant is sleeping on a soft mattress or with bedding, stuffed toys, or a pillow near the face. In that scenario, the soft surface could create a small enclosure around the baby’s mouth and trap exhaled air. As the baby breathes exhaled air, the oxygen level in the body drops and carbon dioxide accumulates. Eventually, this lack of oxygen could contribute to SIDS.

Other steps to reduce SIDS risk include:

  • Use a firm sleep surface: A firm crib mattress, covered by a sheet, is the recommended sleeping surface.
  • Keep soft objects and loose bedding out of the crib: Pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects should be kept out of an infant’s sleeping environment.
  • A separate but nearby sleeping environment is recommended, such as a separate crib in the parents’ bedroom. Bed sharing during sleep is not recommended.
  • Consider offering a pacifier at nap time and bedtime. The pacifier should be used when placing the infant down for sleep, and not be reinserted once the infant falls asleep.
  • Preventing an infant’s exposure to second-hand smoke is advisable for numerous reasons in addition to lowering the risk of SIDS.
  • Avoid overheating: The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult. Studies show that opening a window in the infant’s room reduces the risk of SIDS by 36% and using a fan in the infant’s room reduces the risk of SIDS by 72%.
  • Avoid commercial devices marketed to reduce the risk of SIDS. Although various devices have been developed to maintain sleep position or reduce the risk of rebreathing, none have been tested sufficiently to show efficacy or safety.
  • Avoid development of positional plagiocephaly (flat back of head) by giving baby plenty of “tummy time” when he or she is awake.
  • The infant should not spend excessive time in car-seat carriers and “bouncers.” Place the infant to sleep with the head to one side for a week, and then change to the other.
  • Make sure your baby has regular “well-baby” checkups.
  • If your baby had GERD, be sure to follow the pediatrician’s guidelines on feeding and sleeping positions.

Ensure that others caring for the infant (child care, relative, friend, babysitter) are aware of these recommendations.

Source: http://sids.org/, Wikipedia, Mississippi State Department of Health, 10-21-2008